Exploring the link between household structure and women's household decision-making autonomy in Mauritania.

Governments in sub-Saharan African countries aim to increase married women's household decision-making autonomy as it remains a critical determinant of desirable health behaviours such as healthcare utilisation, antenatal care visits, and safer sex negotiation. However, very few studies explore how household structure (i.e., monogamous or polygamous) is associated with married women's household decision-making autonomy. Our paper seeks to address this gap. Using the 2019-20 Mauritania Demographic and Health Survey, a nationally representative dataset, and applying logistic regression analysis, we explore how married women's household structure is associated with their household decision-making autonomy. We find that 9% of married women are in polygamous marriages, while 63% and 65% are involved in decision-making about their health and large household purchases, respectively. Additionally, 76% and 56% are involved in decision-making about visiting family or relatives and household expenditures. After accounting for socio-economic and demographic factors, we find that compared to women from monogamous households, those from polygamous households are less likely to participate in decision-making about their health (OR=0.65, p < 0.001), making large household purchases (OR=0.65, p < 0.001), visiting family or relatives (OR=0.72, p < 0.001), and household expenditure (OR=0.58, p < 0.001). Based on our findings, we recommend the urgent need to review and re-evaluate policies and approaches seeking to promote gender equality and women's autonomy in Mauritania. Specifically, it may be critical for intervention programmes to work around reducing power imbalances in polygamous household structures that continue to impact married women's household decision-making autonomy adversely. Such interventions should centre married women's socio-economic status as a central component of their empowerment strategies in Mauritania.

Maternal Tetanus Toxoid Vaccination in Benin: Evidence from the Demographic and Health Survey.

Tetanus toxoid vaccination is critical for improving maternal and child health. Yet, the prevalence and correlates of maternal tetanus toxoid vaccination coverage remain largely underexplored in Benin where infant and child mortality rates are high. Using the 2017−18 Benin Demographic and Health Survey, we apply logistic regression analysis to address this void in the literature. We find that overall maternal vaccination coverage is 69%. A range of demographic, health care, and socioeconomic factors are associated with maternal tetanus toxoid vaccination coverage. Women aged 20−34 (OR = 0.84, p < 0.05) and 35−49 (OR = 0.63, p < 0.01) are less likely to receive tetanus toxoid vaccination in comparison to those aged 15−19. Health care factors are also significantly associated with maternal tetanus toxoid vaccination, indicating that women who deliver at home (OR = 0.20, p < 0.001) and visit antenatal care fewer than eight times (OR = 0.62, p < 0.001) are less likely to receive tetanus toxoid vaccination than their counterparts who deliver in a health facility and visit antenatal care eight times or more. We also find that women with secondary (OR = 0.54, p < 0.05), primary (OR = 0.47, p < 0.01), and no education (OR = 0.47, p < 0.01) are less likely to receive tetanus toxoid vaccination compared to their counterparts with higher education. Based on these findings, we discuss several implications for policymakers.

Understanding the Link between Household Food Insecurity and Self-Rated Oral Health in Ghana.

There is increasing scholarly attention on the role of food insecurity on the health of older adults in sub-Saharan Africa, including Ghana. Yet, we know very little about the association between food insecurity and self-rated oral health. To address this void in the literature, this study uses a representative survey of adults aged 60 or older from three regions in Ghana to examine whether respondents who experienced household food insecurity rated their oral health as poor compared to their counterparts who did not. We found that 34% of respondents rated their oral health as poor, while 7%, 21%, and 36% experienced mild, moderate, and severe food insecurity, respectively. Moreover, the results from the logistic regression analysis showed that older adults who experienced mild (OR = 1.66, p < 0.05), moderate (OR = 2.06, p < 0.01), and severe (OR = 2.71, p < 0.01) food insecurity were more likely to self-rate their oral health as poor, compared to those who did not experience any type of food insecurity. Based on these findings, we discuss several implications for policymakers and directions for future research.